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Arthritis

Overview

Arthritis is a broad term for joint inflammation, covering various conditions that affect the joints. It can cause pain, swelling, and stiffness, with severity ranging from mild to debilitating. Arthritis can significantly impact the quality of life.

Arthritis is categorised into the following types:

  • Osteoarthritis (OA): This is a degenerative joint condition associated with cartilage degeneration, which causes joint stiffness and pain; OA is the most common type of arthritis.
  • Inflammatory arthritis: This represents an autoimmune condition; the immune system mistakenly recognises the joint's synovial lining as ‘foreign’ and attacks it, leading to inflammation and pain. Common examples include rheumatoid arthritis (RA), ankylosing spondylitis (often affecting the spine), and psoriatic arthritis (linked with skin lesions).
  • Gout: This condition arises from the build-up of uric acid crystals in the joints, causing sudden, intense pain, typically in the big toe.
  • Juvenile arthritis: This type of arthritis typically occurs in children under the age of 16.

  • Ageing is the most common cause of arthritis, with the exception of juvenile arthritis.
  • According to gender differences, Some types of arthritis like RA and lupus are more common in women than men.
  • A family history of arthritis can increase the risk of developing specific types of arthritis, such as OA and RA.
  • Obesity has also been reported to serve as a risk factor for arthritis, given that excess weight puts pressure on the joints, particularly those associated with carrying weight, such as the knee joints.
  • Previous joint injuries or repetitive strain can lead to a higher likelihood of developing secondary osteoarthritis (OA).
  • People with autoimmune disorders may have an increased susceptibility to arthritis.

  • Persistent or occasional joint pain, particularly in weight-bearing joints, such as the knee and ankle joints
  • Swelling caused by inflammation in the affected joints
  • Stiffness, especially noticeable in the morning or after prolonged inactivity
  • Limited range of motion, causing difficulties in joint movement
  • Warmth and redness, commonly seen in inflammatory types of arthritis like rheumatoid arthritis (RA)

  • Physical Examination: The physician evaluates joint swelling, tenderness, range of motion, and overall joint function.
  • Medical History: This involves the discussion of the severity and duration of symptoms and any family history of arthritis.
  • Blood Tests: These help assess the levels of inflammation-specific markers, such as the erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), autoimmune antibodies (e.g., rheumatoid factor for RA), and uric acid levels (for gout).
  • Imaging Studies: X-ray or magnetic resonance imaging (MRI) helps to assess structural changes in the joint and ascertain the severity of joint damage and inflammation.

Non-surgical treatment

Non-surgical treatment methods vary depending on the type and severity of arthritis; one or more of the following methods may be used:

  • Medications:
    • Analgesics: Mainly non-steroidal anti-inflammatory drugs (NSAIDs).
    • Disease-modifying antirheumatic Drugs (DMARDs): Used for rheumatoid arthritis (RA) and other inflammatory types of arthritis.
    • Urate-lowering medications: For managing gout.
  • Physical Therapy: Exercises for enhancing muscle strength and flexibility.
  • Lifestyle Modifications: Weight management, joint protection strategies, and regular exercise.

Surgical treatment

For patients with severe arthritis, surgical procedures, such as joint replacement or arthroscopy, may be necessary. Overall, a multidisciplinary approach is often required to effectively treat specific types of arthritis based on the severity of the condition.

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